The Attacks on Homeopathy in the UK – Could it happen here
by Carol Boyce
As surprising as it might be, the presence of homeopathy in the U.K., introduced by Dr Quin in 1828; sanctioned by the government; and an integral part of the U.K. National Health Service (N.H.S.) since its inception in 1948, has been fighting for its life.
It seems no accident that the present threat to the practice of homeopathy began in the UK and in particular at the Royal London Homeopathic Hospital (RLHH). The 150 year- old RLHH provides a touchstone in the world of homeopathy and a reassurance for any potential newcomers to the field, especially in the developing world, that homeopathy is a valid system of medicine.
If a media headline can proclaim that homeopathy is no longer available within the U.K. N.H.S., not because there is insufficient funding but because it has been proven ineffective and officially removed, then the aftershocks will be felt in every corner of the homeopathic world. It would be the coup de grâce that began with the flawed science and vested interests behind that fateful ‘anti-homeopathy’ edition of The Lancet just three short years ago.
Research has revealed a well-planned and orchestrated campaign involving many players: some well aware of their actions; others duped into following their lead and still others too afraid of ridicule from peers to voice their reservations.
Proof that homeopathy doesn’t work – a little history
In August 2005, The Lancet published its “End of Homeopathy” edition, including the fundamentally flawed Shang et al. meta-analysis (1), which purported to “prove” once and for all that homeopathy is no better than placebo; an anonymous editorial, “The End of Homeopathy”, which implored doctors to be “honest with patients about homeopathy’s lack of benefit”; and a fierce criticism of the leaked pro-homeopathy World Health Organization (WHO) draft report, which was later withdrawn for revision and to date has still to be published.(2)
The Shang et al. meta-analysis can be dismantled by anyone willing to read the entire paper and not simply the title and conclusion. Of the 110 trials of homeopathy that matched the study’s criteria, the authors reached their conclusion by using just eight trials — and the eight used were not identified in the published paper! At the insistence of members of the homeopathic medical community, the eight trials were eventually revealed, and it became clear that extreme “cherry-picking” had transpired; only these eight particular trials would lead to a negative result. A meta-analysis using other combinations of the 110 trials available would weigh in favor of homeopathy. To see just how flawed the “science” is, see the “Proof against homeopathy does in fact support homeopathy”, a detailed critique of the Shang paper (3); and “The growth of a lie and the end of “conventional” medicine”, by two Italian physicians, which lays out the vested interests at work.(4) (Shang was part of the group who provided the highly criticized meta-analysis for the Swiss Program Evaluation Komplementärmedizin in 2003, which led to the withdrawal of homeopathy from Swiss health insurance. Richard Horton, The Lancet editor, is openly antagonistic to homeopathy, and Sir Crispin Davis, CEO of The Lancet’s publisher Elsevier (annual budget 5 billion GBP), is a (non-executive) director of GlaxoSmithKline.)
The WHO report was leaked by Renckens, a gynecologist and chair of the Dutch Union Against Quackery and another vocal critic of homeopathy. Willem Betz, chair of the Study Circle for the Critical Evaluation of Pseudoscience and
the Paranormal, drew a comparison with the WHO 2003 report, also heavily criticized because it stated that acupuncture had been shown in trials to be effective. In an expression of outrage Betz declared that “WHO has been
infiltrated by missionaries for alternative medicine”.(2) Professor Ernst, the UK’s first and only university Chair of Alternative and Complementary Medicine (as late as 2003, a supporter of homeopathy; now one of its most outspoken critics(5)), called for the report’s withdrawal for revision demanding a full disclosure of names of authors and any conflicts of interest. In an interesting Freudian slip, the same Lancet article states: “Renckens argues that it is wrong that such reports should not be prepared in secret behind closed doors...” (my italics).
The Long Arm of the Lancet
The impact of this Lancet attack has been huge and the fallout, extensive. After all, The Lancet is one of the oldest peer-reviewed medical journals in the world, and ranks third on the impact listings of Epidemiologi.org.
In a series of apparently unrelated yet perfectly timed events in different formats, and using the Shang meta-analysis as ‘proof’, high-ranking medical professionals in the UK have demanded that public money not be spent on an ‘ineffective, impossible, implausible’ therapy. Strategically leaked reports; letters from 13 of the U.K.’s most eminent medical professionals to area Primary Care Trusts (P.C.T.s) (responsible for funding health care) across the nation, insisting that they stop providing homeopathy as a patient option; and a continuing plethora of newspaper articles and books have served to keep homeopathy in a negative spotlight.
A number of P.C.T.s, have folded under intense pressure from this small but vocal anti-homeopathy medical contingency and have withdrawn funding for GP referrals to homeopathic doctors and funding for the homeopathic hospitals. In January 2008 Pulse, the newspaper for doctors estimated that more than 25% of PCTs had withdrawn funding for provision of homeopathy, with more set to follow. (6).
Despite the total budget for all the homeopathic hospitals running to 10 million GBP in a total NHS budget of 76 billion GBP, the RLHH has suffered serious cutbacks. The hospital is now squeezed into just one floor of what was once an entire building, and that shared with all other complementary therapies and support staff. Outpatient clinics have been restricted and some patient referrals denied. Threat of closure of even this small provision still looms large despite fully booked clinics, and the fact that the RLHH is, “… over-performing on their contract..” and “…. ahead of its target for numbers of new and follow-up patients set by the University College London Hospital(s) Trust.” (the management). (7)
Not surprisingly, staff morale is low. There is talk of keeping some of the RLHH’s clinics (the arthritis clinic which uses specific symptomatic acupuncture, for example) — but removing the homeopathic clinics completely. One possible outcome would be a much reduced non-homeopathic CAM service provided as an adjunct to the allopathic University College Hospital. The P.C.T.s responsible for most of RLHH’s funding are expected to give their final decision at any time.
The Tunbridge Wells homeopathic hospital was scheduled to close by March 2008 but there was brief cause for celebration when the concerted effort of its loyal patients and their supporters secured a one-year reprieve, and thus continued provision of homeopathy to its patients in the interim. The Bristol and Liverpool homeopathic hospitals are still functioning, albeit as outpatient clinics in small separate premises: a stark contrast to the busy hospitals they once were, but at least for now, still able to offer N.H.S. homeopathy. Bristol’s new referrals tend to be from oncologists wanting support for patients suffering the side-effects of cancer treatment. The Glasgow Homeopathic Hospital alone seems to be safe, strongly supported by GP referrals within the Scottish N.H.S after powerful lobbying by the public.(7)
In the wider homeopathic community individual homeopaths, both professional and medical, report falls in the number of new patients. Homeopathic training institutions are experiencing some of the lowest enrolment in memory and reductions in patient numbers and college enrolments have been reported in places as diverse as The Netherlands, Poland, and Germany, all countries where homeopathy has a strong history. In the homeopathic developing world of African countries, small clinics run by devoted clinicians are still alive and busy but suffering their own crises of funding and logistics.
Homeopathy’s critics have become increasingly confident and determined over the last three years. The flawed Shang meta-analysis has provided them with “the defining proof” of homeopathy’s ineffectiveness, and potentization, “scientifically impossible” (and much misunderstood) has provided the focus for much ridicule and school yard humor.
Deconstructing the campaign
Once the object of ridicule themselves, Quack Watch groups have been repackaged as slick, well funded, and apparently credible organizations, with apparent representatives in influential positions throughout media organizations. (As an example see www.badscience.net, the website of Dr. Ben Goldacre, the health reporter for the prestigious Guardian newspaper.)
The thousand word tirade by Emeritus Professor Michael Baum, surgeon and oncologist titled “Homeopathy Is Worse Than Witchcraft” and published in the national newspaper, The Daily Mail, was astonishing in both its ignorance and its ferocity. Yet it exemplifies the mixture of ridicule and accusation increasingly adopted by the critics in the many anti-homeopathy articles published in prominent newspapers over the last three years. (8)
In June 2006, the BBC conducted a “sting” of homeopaths for its TV program “News Night”, exposing the “threat to public health” posed by homeopaths who had suggested homeopathic prophylaxis for malaria. Sense about Science, an openly anti - CAM organization established to “educate the public” and funded by corporate interests, (including the Association of the British Pharmaceutical Industry and individual pharmaceutical companies), sent a reporter, posing as a patient, to ask for homeopathic advice about protection against malaria for a forthcoming overseas trip. The media had a field day and continues to berate the homeopathic community’s delusion and their lack of ethics. The fact that a representative of the Society of Homeopaths appeared on the BBC and did not condemn their members’ behavior served to add fuel to the fire. (9)
In November 2007, The Lancet published a second ‘anti-homeopathy’ issue apparently timed to coincide with a UK Parliamentary motion to discuss provision of NHS homeopathy. Three articles– two without a single reference – and all damning homeopathy, took advantage of the opportunity to reiterate previously stated criticism by the same small group of high ranking medical professionals or science writers. Analysis of these articles is useful because they provide excellent examples of the writing technique used in the campaign as a whole, but it also raises the question: are they really Lancet material? The Lancet’s disinterest in hosting a second side to the debate about homeopathy, in fact-checking, or even in requiring references for the articles published must reflect a decline in the very standards for which it originally gained global respect. Is it now sufficient for publication in The Lancet that the article disparage homeopathy? (10, 11, 12)
Who are these people?
It is interesting to take a moment to consider the interrelationships of this small but most vocal group of anti-homeopathy campaigners:
• Dr Ben Goldacre, Guardian science journalist and owner of badscience.net, and recipient of a HealthWatch award;
• Professor Baum, high-ranking oncologist and founder member of the Campaign Against Health Fraud (initially funded by the health insurers PPP and Astra Pharmaceuticals) and now HealthWatch, and recipient of a HealthWatch award;
• Professor Colquhoun, retired pharmacist and owner of the Improbable Science site which supports the articles of the previous two;
• Scientist Richard Dawkins, vehemently pro-materialism and presenter of the 2007 U.K. Channel Four T.V. series “Enemies of Reason” which slammed homeopathy;
• John Maddox, the editor of Nature, instrumental in discrediting Benveniste’s work on the memory of water; on the Board of Trustees of Sense about Science and a member of CSICOP (the Committee for the Scientific Investigation of Claims of the Paranormal, now partially repackaged as the international Skeptics movement);
• The infamous magician James Randi, who runs the James Randi Educational Forum, instrumental in discrediting Benveniste’s work on the memory of water;
• Simon Singh, physicist, on the Board of Trustees of Sense about Science, part of the Newsnight ‘sting’, co-author of Trick or Treatment, Alternative Medicine.
• Professor Edzard Ernst, holding the U.K.’s only university Chair of CAM; possibly the U.K.’s most outspoken critic of homeopathy; and consulted as an expert by the media and co-author of Trick or Treatment. Professor Ernst gave the keynote address to the 11th European Skeptics Congress, held in London in September 2003, the title of his presentation was “Complementary and Alternative Medicine for skeptics”. He received the HealthWatch award in 2005 for “his honest appraisal of CAM”. (13,14,15,16,17)
From this mélange of overlapping interests there emerges an unpalatable issue for a healing profession: the possibility that the agenda, the motivation, the campaign, and the players are politically motivated. They profess to carry the banner of healthy skepticism, asking only for evidence. But when evidence is presented that does not fit with their beliefs, they dismiss it as implausible.
Members of these organizations and their associates endorse each other, quote each other’s (often unsubstantiated) claims, award prizes to each other (which they then use to add authority to their pronouncements), and are indirectly supported in various convoluted ways via vested interest groups. They represent that the only reason for so much negative media attention on homeopathy of late is that finally the “truth” — which they have tried to tell the gullible public all along — has been proven once and for all by the Shang meta-analysis — and that its publication in The Lancet is de facto proof that it must be true. They claim that homeopathy is no better than placebo and that therefore as a profession homeopaths make fraudulent claims, peddle in false hope, and dupe the poor unsuspecting public, who are incapable of critical thought.
The narrow focus of all these individuals is debunking, not rational discussion. Directly or indirectly, they serve the interests of corporate medicine and the deregulation of industry. The anti-homeopathy campaign has skillfully focused on emotionally charged (if factually misleading) articles appealing to the (largely) poorly informed public. Their authors have ready access to the mainstream media, which, like The Lancet, have been all but closed to the pro-homeopathy side of the case. A small sampling of their work quickly reveals circular arguments and wild accusations, spin and misquotes, ridicule and character assassination, and a retreat to the safety of righteous indignation or of endless parental patience and super-rationality.(18, 8) The cause for concern, however, is that these people represent themselves as expert on important subjects in which they have no credentials, relying on constant repetition of select marketable opinion, for example the Shang study, to transform inaccurate statements into “scientific facts”.
(Martin Walker, author of Dirty medicine: Science, big business and the assault on natural health care, has recently published long, highly detailed, fully referenced e-books about the complex web of the anti-CAM world. They make fascinating reading and provide valuable clarification of an otherwise impenetrable subject. (19,20,21))
Professor Edzard Ernst is on a roll. Were he still living, Maurice Laing, of the U.K. building company of the same name, may be ruing the day he expressed his philanthropic inclinations by funding the UK’s first chair in complementary and alternative medicine (CAM) at a British university, a position held by Professor Edzard Ernst from Vienna.
When first appointed to his position at Exeter University, Ernst announced that it was important to support CAMs with hard evidence and proposed a series of clinical trials, an announcement initially welcomed by the CAM community. As late as 2003 on record as a supporter of homeopathy, Ernst is now its biggest critic. With more than a thousand published papers to his credit, he has been elevated by the press to the world authority on the scientific evidence for CAMs, and his opinion is now quoted as fact. (22)
Citing lack of funding, Ernst’s own department has conducted no new trials for the last several years and has restricted itself to systematic reviews and meta-analyses. The methodology of the trials that he has conducted on homeopathy is poor and his investigation into the efficacy of the medicine Arnica is a good example. (23) Ernst chose to test Arnica in patients following wrist surgery, and then concluded that Arnica was no better than placebo. A student with a first-aid homeopathy course under her belt would know that Arnica is most effective for soft-tissue contusions.
In surgery, especially on a joint, other homeopathic medicines would be better indicated, such as Ruta graveolens for damage to tendons and periosteum; Rhus toxicodendron for muscle damage; and Hypericum for nerve damage. (Yet a rebuttal by Dr. Peter Fisher et al. (24) of the conclusions of Ernst’s Arnica trial showed that even in this context, when the results were properly analyzed, Arnica still performed better than placebo.) We can only wonder whether Ernst can really be this ignorant about the homeopathic method or has another agenda.
In April 2008, and to much fanfare, Bantam Press released its Trick or Treatment: Alternative Medicine on Trial, by Edzard Ernst and his co-author Simon Singh, science writer behind the BBC Newsnight sting in 2006. Their book has been heralded as a rigorous scientific analysis of the evidence (or lack thereof) in support of CAMs. A book to finally put to rest all the questions and confusions the public might have about CAMs in general, and in particular about the “big three”: homeopathy, acupuncture and chiropractic. Much of the evidence he quotes, together with the systematic reviews and the meta-analyses which form the basis of the book are the work of his own department and the two authors, neither with verifiably credible training in CAMs, have written what is rapidly becoming the best-selling, definitive guide on the subject. Reviewing CAMs from A to Z, the co-authors claim, amongst other things, that there is no evidence to suggest that homeopathy is more effective than placebo; that chiropractic is ineffective and dangerous, with serious risk of spinal injury or subsequent stroke; that acupuncture may offer some help in pain relief and nausea but is otherwise ineffective and possibly dangerous, since the needles may pierce a nerve or organ: that though some herbal products may be effective, most are not and some are potentially dangerous; and so on. Once again the same few names appear in reviews of the book.
The Sunday Time's stated: “Fearless, intelligent and remorselessly rational, the authors exemplify the same Enlightenment spirit of criticism that animated The Lancet in its early days.” (25)
The site spiked–online.com ran a piece, “Trick or treatment? The truth about homeopathy. Continuing our debate on 'The Best and Worst of Medicine', Michael Baum and Edzard Ernst call for homeopathy to be put in the sin bin of history”. (26) On Amazon.com, the same Michael Baum — professor emeritus of surgery, leading oncologist, well-known vocal homeopathy critic, and, apparently, occult investigator — upheld the tradition of mutual endorsement by writing a glowing review:“....This book shines the light on the ignoble practices of alternative medicine… The light that illuminates the book is that of the scientific method. The first chapter beautifully describes the transparency and intellectual honesty of this approach… others who might earn a living by practicing [sic] these dark arts might avoid the truth for fear of recognizing their self delusions”,— and, in a reference to Prince Charles, to whom the book was pointedly dedicated —“… some politicians or members of the nobility might wish to ignore these truths out of political expediency…"— and, after referring to the papal legates who refused to look through Galileo's telescope —"Anyone who refuses to read this book in case it might damage their faith in homeopathy for example, falls into the same bracket. ”Perhaps most telling was Baum's parting remark — “This book serves us well by setting a limit to our ignorance about the nature of disease and its palliation” (my italics). (27) Baum’s review was followed by one from John Garrow, emeritus professor of Human Nutrition at London University and vice-chairman of HealthWatch (the quack-busting organization that awarded Ernst the 2005 prize for his “honest appraisal" of CAMs). In it, Garrow asserted: “What was needed was a thorough audit by competent unbiased clinical scientists to see if these myth-based treatments actually did the patient any good. This book is the auditor's report”.(28)
A Change of Tone
An interesting new term has made its way into the anti-CAM vernacular. Playing on the split between rational science and the “delusion” of religion is the critics’ use of “faith based medicine” as a descriptive for CAMs in general. Simon Hoggart typified the tone in his op-ed piece in The Guardian: discussion of a Malaysian cult that worships a teapot led straight into three paragraphs beginning: “Another quasi-religion - a belief system that requires faith without evidence — is homeopathy”. Describing Trick or Treatment, Hoggart continues, “It's a dispassionate look at alternative medicines from aromatherapy to qijong [sic] and shiatsu. Not surprisingly, they conclude that the only real value of homeopathy is as a placebo...”. (29)
In the same week, The Times ran an article titled “Homeopathy — what a waste of time”, in which Singh asserted:“… There have been more than 200 trials investigating homoeopathy and the overall result is that its remedies are utterly bogus”. Meanwhile The Economist reported the news about the new regulatory Complementary and Natural HealthCare Council (CNHC) in an article titled “Trust me, I've got a license. Regulating the quacks”. (30) A distinctly new kind of criticism for homeopathy arrived this year with the suggestion that homeopathy is actually capable of harm. Damian Thompson, (author of, Counterknowledge: How we surrendered to conspiracy theories, quack medicine, bogus science and fake history, Atlantic Books), writing for The Telegraph “The last rites for alternative medicine?”, made a series of inflammatory and inaccurate statements that included: “'respectable' British homeopaths continue to turn a blind eye to the prescription of lethal homeopathic Aids [sic] treatment by their maverick colleagues” (31), presumably referring to some members of the Faculty of Homeopathy, who, in an apparent attempt to distance themselves from what has been portrayed by the media as the worst excesses of homeopathy’s “delusion”, have publicly denounced the suggestion that homeopathy has any part to play in the treatment of AIDS or the prevention of malaria. (32)
A Dangerous Placebo
Homeopaths are caught in the pincer grip of politics masquerading as hard science: homeopathic remedies, goes the argument, must be merely placebo; therefore homeopathic pharmacies are by definition unethical and homeopaths are dangerous; and the public, unable to think for themselves, need to be protected. The entire argument for this approach is of course predicated on the Shang meta-analysis having been a significant piece of unbiased research, which it clearly was not, and on an obsession with Avogadro's number and the dilution factor in potentization (33). As Sir Martin Rees, president of the Royal Society said in 2006, “…the possibility of a medicine working in this way would ‘entail some fundamentally new scientific principle with amazingly broad ramifications’”. (34) Exactly. The work of highly respected scientists like Ennis, Roy and Bell have replicated experiments demonstrating that high dilutions are biologically active and very different from plain water (35,36,37,38,39,40), but their work is dismissed as irrelevant or conveniently ignored.
Ernst, as the UK’s “leading scientific expert” on CAMs, no longer needs to reference the Shang meta-analysis, but simply states as if accepted fact: homeopathy is placebo despite the fact that a cursory literature search and honest analysis quickly clarify that this is not the case. Even with the constraint of a specific diagnostic label, evidence of homeopathy’s efficacy is readily found.
In an era of Evidence Based Medicine, and calls for homeopathy to ‘prove itself’, Bell and Pappas (41) explicitly detail the subtlety of research design required to adequately test homeopathy. Individualization of prescription; the need to change remedy and dosage according to patient response; continuing accordance with the Law of Cure's requirement that older and more trivial symptoms disappear last; an understanding that a genuine cure may take longer than the average length of a study, and that homeopathy treats the patient and not the named disease, are just some of the essential criteria. All the more remarkable then that homeopathy has produced positive results, even when bound by the inappropriate constraints of allopathically skewed research protocols.
The Alliance for Natural Health, the U.K. group that has doggedly challenged the restrictive Codex Alimentarius regulation of natural health products in the European Courts, is working with a group of scientists to thoroughly investigate the validity of applying the “gold standard” of Evidence Based Medicine to the CAM world. Homeopaths should await their findings with interest. According to the critics, the greatest danger posed by homeopathy remains that patients seeking help from a homeopath might lose valuable time, as they should be consulting an allopathic doctor. The tone used by the critics has recently shifted gears again, to that of paternalistic psychiatrist, sympathetically bringing homeopathy’s “delusions” to attention, while advocating strong measures to ensure that homeopaths are prevented from harming the vulnerable pubic. It is but a small step from there to specific legislation to "protect" the public. On 17 June 2008, Ernst described homeopathic treatments as a "public health problem" and called for tighter regulation. His comments came as a U.K. Government report called for "urgent" controls on herbalists, acupuncturists, and traditional Chinese medicine (TCM) practitioners "amid fears over patient safety".(42) Whether the government ministers have been alarmed by the "scientifically controlled audit" of Ernst and Singh's bestseller or this is simply another coincidence is difficult to ascertain.
In late July, Ernst demanded that the Royal Pharmaceutical Society (RPS) take action to prevent its members acting unethically by selling homeopathic medicines in their shops. Ernst wrote to the RPS demanding that pharmacists, “………inform their customers that a homoeopathic remedy is devoid of any biologically active material and it has not been shown to have relevant health effects beyond placebo.” Interestingly there was no call for pharmacies to stop selling homeopathic medicine as long as they clearly explain to the patient that the effect would be simply placebo. (43)
Signs of change
In early January 2008, the U.K. Government’s Foundation for Integrated Health (F.I.H.) announced the creation of the Natural HealthCare Council. From summer 2008, the Council will function as a voluntary federal register and regulator for the therapies involved. Though not part of the development process, homeopathy has been included. This is widely thought to be one step toward statutory regulation, a move welcomed by the profession; but already the question has arisen of who sets the standards, and in consultation with whom. The U.K. homeopathic profession is self-regulated, and, as an autonomous clinical modality, does not fall easily into the complementary remit. The U.K.’s professional homeopathic organizations are confident that the standards required by the regulatory CNHC will be lower than the standards already required by the homeopathic organizations themselves. (Time will tell whether allowing a government-funded body to dictate the standards of training, without consultation with the profession itself, sets a dangerous precedent in the current climate.) (30)
In recent months the critics have focused almost exclusively on homeopathy’s supposed placebo effect and the unethical nature of describing it as treatment, especially for those suffering identifiable disease states. OnMedica News reported research into the potential value of giving placebos to patients, published in the Journal of Medical Hypotheses. The Dutch researchers suggested that placebos could be used to help doctors, “….steer patients away from unproven alternative therapies..” since, “…fake treatments are typically left to practitioners of so-called alternative medicine who are often not even aware of the ethical dilemma…." (44)
And from Financial Times Weekend columnist Margaret McCartney an article titled, “Homeopathy - good news” in which she writes, “One of the medical newspapers, Pulse, has a news article saying that there has been a drop in the number of homeopathic prescriptions by GPs in the UK. In 2005, there were 83,000 written, and in 2007, it had fallen to 49,300. This is good news.” She goes on to talk about the benefits of placebo, points out the ethical dilemma of knowingly prescribing placebo and calls for the National Institute for Clinical Excellence (NICE) to evaluate homeopathy as it does other medicine also found to be ineffective and hence not to be funded by the NHS. (45) But in the same few weeks there has also been some welcome news and positive articles in the UK press and a sense that the homeopathic community is quietly organizing itself.
The Faculty of Homeopaths have published the positive results of a pilot study into patient satisfaction at the homeopathic hospitals (1,602 patients seen at follow-up, “almost 60% reported an improvement in health that affected their daily lives.”), given an alternative analysis of why GP homeopathic prescriptions seem to have fallen so dramatically (the cost of buying homeopathic medicine OTC is often less than an NHS prescription and therefore the patient’s choice, only a tiny proportion of the materia medica is included in the GP software, most prescriptions are hand written and not always entered into the GP data), and stated clearly that despite the barriers put up by individual health providers, “…referrals to NHS homeopathic services remain steady and over the counter sales are increasing…” apparently as far as the general public is concerned, there is no decline in the popularity of homeopathy. (47)
The public does not seem to have been effected by much of the negative press. Those for whom conventional medicine has not provided an answer will, of necessity, seek out alternatives. What has been affected are the administrators of the PCTS responsible for funding the homeopathic services. Referring to the decision to close Tunbridge Wells in Spring 2009, Dr James Thallon, Kent PCT's medical director, stated, “…. ultimately it is the clear duty of PCTs to make best use of public money by commissioning clinically cost-effective care……There is not enough evidence of clinical effectiveness for us to continue to commission homeopathy." One of the hospital's senior doctors, Dr Helmut Roniger, said: "Money didn't play much of a role in this decision - our service is very cheap, but the trust can’t understand how homeopathy works and doesn’t have enough 'evidence' in this evidence-based market to support it.” He went on to add, "Most medicine still practiced today is non-evidence based. We really should not be depriving people of this cheap, effective and historic method of treatment." (48)
In the recent research into provings, published in the Journal of Psychopharmacology, two double-blind placebo controlled trials showed significantly more remedy-specific symptoms in provers taking ozone or iridium than in provers taking placebo, and concluded that, “…homeopathic remedies produce more symptoms typical for a remedy than non-typical symptoms.” (49)
Philosopher Arthur Schopenhauer is credited with the observation that a new idea undergoes several phases before acceptance. First it is ridiculed; then it is vehemently opposed; when support begins to gather, it is described as possible but not relevant; still later it is admitted to be true and relevant but not original, whereupon former critics claim credit for it; eventually it is criticized as being too obvious to warrant mention. It may be worth considering where homeopathy lies on that continuum. (50) Given the extensive work in materials science and immunology, and most recently the research into homeopathic provings, it seems only a matter of time before homeopathy is finally vindicated. For the professional homeopath this may bring the additional challenge of establishing the right to practice.
Don’t Panic
This latest anti-homeopathy furor should be taken as a wake-up call. If homeopathy were not perceived as a threat, there would be no need for an opposition, furthermore homeopaths can consider themselves to be in good company; they have been the subject of derision since Hahnemann wrote the Organon! It’s important to rise above the ridicule and not waste precious energy debating the issues in an allopathic arena, with critics who have no interest in hearing what homeopaths have to say. Instead use that energy most efficiently to focus on those who are open to the evidence. As a profession, the homeopathic community must come of age, and quickly. It should hone the definitions of homeopathy, be able to quote recent relevant scientific developments and speak with authority about the work of homeopaths. Homeopathic practitioners should cleave to their code of ethics and be the best possible ambassadors for homeopathy that they can be. Internal debate about methodologies should be conducted with the mutual respect the old masters afforded each other. Succinct and accurate submissions for use in online discussions should be developed urgently. (I know from my own recent experience with the RLHH how time-consuming and repetitive that can be.)
Homeopaths need to stay awake and stay informed, and where necessary wake each other up. New practitioners need to join their professional bodies and help them serve the profession’s best interests in these times of rapid change; share information; be ready to respond to proposed changes in legislation, and be able to quickly mobilize grassroots support. The profession needs to reach out and build bridges with other homeopathic communities to create a coherent global movement, potentially encompassing some half a billion people! To reach out and build bridges with the wider CAM community and with all open-minded allopaths; learn from the UK homeopathic community and pool resources to ensure that the professional homeopath retains the right to practice; demand appropriate research methodologies that can adequately demonstrate homeopathic action on homeopathy’s terms, and develop efficient methods of training many more homeopaths, with specific education to help interested allopaths get up to speed.
Consider the prospect of witnessing homeopathy as mainstream medicine in this lifetime, hold that vision and be ready to take on the challenge of all that it will mean.
Based on a series of articles published in Similia:
Magnus Pharma and the Golden Goose Similia vol. 19 no. 1 June 2007
Homeopathy and Humbug Similia vol. 19 no. 2 Dec 2007
Edzard Ernst and the Ultimate Delusion Similia vol. 20 no. 1 June 2008
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Carol Boyce, BSc, MCH, CCH, RSHom(NA), homeopath, teacher, writer, graduated from the College of Homeopathy, London, in 1985. As a founder and director of the forerunner to Homeopaths Without Borders U.K., she set up homeopathic teaching and clinical projects from Calcutta to Cairo and took homeopathy to Baghdad after the first Gulf war and taught in medical schools in Cuba with HWB U.S. She teaches in schools across the U.S. and is currently making a series of documentary films about homeopathy.
